Life-threatening overdose with lamotrigine, citalopram, and chlorpheniramine.
Lamotrigine is a commonly used agent for seizure control in epilepsy. There are limited data on the adverse effects of lamotrigine in overdose. We report a number of serious side-effects associated with a large overdose of lamotrigine. A 23-year-old female presented to the emergency department after taking an intentional overdose of 9.2 g of lamotrigine, 56 mg of chlorpheniramine, and 220 mg of citalopram. On admission, she had a reduced level of consciousness and electrocardiographic abnormalities; a widened QRS and a prolonged corrected QT (QTc) interval. Prompt treatment with early intubation, along with the use of magnesium for cardioprotection and administration of sodium bicarbonate may have aided in a quick recovery with a short intensive care stay and good outcome.
Venkatraman
N
N
Acute Care Common Stem, University Hospitals of Leicester NHS Trust, Intensive Care Unit, Leicester Royal Infirmary, Leicester, United Kingdom. navinda@doctors.org.uk
O'Neil
D
D
Hall
A P
AP
D000284:Administration, Oral; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000506:poisoning*; D002744:Chlorpheniramine / Q000008:administration & dosage / Q000506:poisoning*; D015283:Citalopram / Q000008:administration & dosage / Q000506:poisoning*; D062787:Drug Overdose / Q000188:drug therapy*; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008133:Long QT Syndrome / Q000139:chemically induced; D011041:Poisoning / Q000188:drug therapy; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000506:poisoning*
D000927:Anticonvulsants; D014227:Triazines; D015283:Citalopram; D002744:Chlorpheniramine; D017693:Sodium Bicarbonate; D000077213:Lamotrigine